Geoff Stetson, MD Profile picture
May 4, 2021 13 tweets 8 min read Read on X
1/ Welcome back to #TweetorialTuesday with the #MedEdTwagTeam!

We are in our #EffectiveQuestions series.

Thanks for joining us, #MedTwitter, #MedEd, & #MedStudentTwitter Friends! Image
2/ Today is Week 2 out of 7 in this series.

Today, we will be covering some general rules about how to ask questions in the clinical learning environment. Image
3/ These are the 8 rules I personally follow. We will get into each one in this thread.

Here are some great papers for more background:
pubmed.ncbi.nlm.nih.gov/32297833/
pubmed.ncbi.nlm.nih.gov/33394663/
pubmed.ncbi.nlm.nih.gov/27541066/ Image
4/ As with all parts of learning in the clinical environment, everything goes smoother when expectations are clear and the curriculum is transparent.

Let learners know that questions are a tool you use to teach, and that they should be ready to participate.
5/ However, you must not use their answer in their evaluations. Make it explicit when setting expectations that you won’t.

This is key to getting full participation. Otherwise, you’ll have learners worrying more about performance than growth.
6/ Along those same lines, saying ”I don’t know” needs to be an okay practice, even encouraged.

This promotes trust, patient safety, and the growth mindset when the learner goes on to fill the knowledge gap.

Right, @DxRxEdu & @rabihmgeha?
7/ You need to know why you are asking a question.
🙏 to: @SonjaRaaum @buckeye_sanjay @LiangRhea @GIMaPreceptor @SonoSamMD & @alvinseattle for sharing their reasons last week.

If you don’t know the reason, you’re probably about to ask a bad question. 👇 are some of my reasons: Image
8/ Don’t interrupt your trainees.

We are trying to create a psychologically safe environment.

Cutting someone off who is sharing their thoughts in front of a group can sting. Bad.

Give them the chance to finish.
9/ Give your learners time to answer your questions.

If your questions take thought (and they should), allow time for thinking. 5 seconds MINIMUM.

Learn to revel in the silence!
10/ Unless, of course, you are getting quizzical looks back. Perhaps, you have asked a “bad question” (more on this next week).

In which case, just apologize, and make your teaching point.

Learners LOVE this. It shows you care, and that you are fallible. Image
11/ Correct incorrect answers. You don’t want your efforts to create a psychologically safe learning environment to inhibit actual learning.

Praise learners’ efforts and engagement, but, gently and clearly, correct any misconceptions.
12/ These were our 8 general rules to asking #EffectiveQuestions.

If there are other guidelines you use, or you have any thoughts, please, comment and share with us all! Image
13/ Alright, friends! Thanks for joining us.

Before we get into some of my favorite reasons and ways to ask questions, we need to talk about "bad questions." That's next week!

Make sure to follow: @GStetsonMD, @JenniferSpicer4 & @MedEdTwagTeam

Until then! Image

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More from @GStetsonMD

May 17, 2022
1/ Attending: “Sam, what is the level of bilirubin at which scleral icterus is noticeable?”

Sam thinking: [1. I can make a guess, but 2. Who cares?]

Seem like a familiar scenario? Let’s help this attending ask a better question.
2/ Whether it is in the team room, or at the bedside, asking questions of learners is a skill that requires intention, preparation, and execution. These best practices were a topic I covered a while back, so this will be a refresher.
3/ These were all the topics that were covered in that series. Each individual thread can be found here:
twitter.com/i/events/13982…
Read 14 tweets
Apr 19, 2022
1/ You just admitted a patient with some really interesting pathology. You want to teach about it tomorrow on rounds. You know it is gonna be a busy day. What’s the plan?

Welcome back to #TweetorialTuesday from the @MedEdTwagTeam. Special S/O to our #MedEd & #MedTwitter friends!
2/ We are still in this “during rounds” section of our inpatient teaching block. Rounds are the CLASSIC time to drop pearls. But, doing it well takes thought and preparation.
3/ What does it mean to “drop pearls”? It refers to pearls of wisdom, and many of us think of some stately professor emeritus waxing poetic in a case conference.

But check out this definition here:
Read 11 tweets
Apr 5, 2022
1/ Welcome back to another edition of #TweetorialTuesday from the @MedEdTwagTeam. Special S/O to our #MedEd & #MedTwitter friends!

Over the last two weeks we have laid out the WHY and the WHAT of teaching communication. Today is the HOW. Let’s go!
2/ For refreshers on the WHY and WHAT, check out these previous threads from:
@JenniferSpicer4 (WHY) –
@GStetsonMD (WHAT) –
3/ And like the previous threads, much of this content comes from this book (Chapter 16 for this thread) by @DrCalvinChou & @LauraCooleyPhD of @ACHonline. It is a foundational book that is extremely readable and applicable. Well worth your time: CommunicationRx.org
Read 12 tweets
Mar 29, 2022
1/ We can’t always treat. We can’t always cure. But we can always support & care with good communication.

Welcome back to our #MedEd & #MedTwitter friends! Today we lay out some foundational skills of communication that you can help your learners to hone under your tutelage.
2/ As we continue to focus on inpatient teaching, we are still in the section that homes in on opportunities during rounds. Especially when rounds are done at the bedside this is a perfect time to practice communication skills.
3/ Last week, @JenniferSpicer4 helped us all to grasp WHY it is important to spend time teaching communication skills:
⬆️Health outcomes & patient experience
⬇️Cost of care
⬆️Clinician experience

Read 16 tweets
Nov 16, 2021
1/ It is near the end of your time on inpatient service and it has been BUSY!

Spirits are high, but folks are tired.
You want to make sure rounds are high-yield, but how to focus their energy?

Welcome back #MedTwitter & #MedEd for another #TweetorialTuesday from @MedEdTwagTeam!
2/ This week, I will share tips on how to use questions to get ”the wheels turning” for your learners before rounds.

In just a few minutes, this focuses energy, engages team members in the cases they may not be following, and enhances bedside learning for everyone.
3/ Today’s 🧵 harkens back to one I posted about ”prediction questions”.

Inspiration: #SmallLearning from @LangOnCourse. It is tremendous, with a lot of useful ideas that can be applied in the classroom or clinical setting. FYI - 2nd ed just came out.
Read 13 tweets
Sep 28, 2021
1/ Learning objectives? For serious?!? 🤔
Aren’t those for boring pre-clinical lectures?
Are they even necessary? I seem to get by just fine without them.

You may get by fine but knowing how to use learning objectives will take your game to a new level. Let's go!
2/ Welcome back, #MedEd and #MedTwitter friends, for another exciting week of learning from the @MedEdTwagTeam.

For orientation, we are still in our foundational skills section of #InpatientTeaching.
3/ Every resident who rotates with me leaves my team knowing why learning objectives (LOs) are important, how to make them, and how to apply them.

LOs provide structure to all didactic content, and IMHO, are the single most useful tool to power up your teaching.
Read 15 tweets

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